目的·探索额叶-边缘系统的功能连接特征在预测精神病临床高危综合征（clinical high-risk for psychosis, CHR）患者转化为精神分裂症中的作用。方法·募集CHR被试164例和健康对照89例，采集静息态功能性磁共振成像，计算基线时额叶（内侧前额叶、双侧眶额）和边缘系统（双侧海马、双侧杏仁核）脑区之间的功能连接强度。CHR组根据1年随访的临床结局被细分为3个亚组，即转化组（CHR-C组，转为精神分裂症）、症状组（CHR-S组，仍符合CHR诊断标准）和缓解组（CHR-R组，症状缓解）。比较额叶-边缘系统功能连接的组间及亚组间差异，分析其与脑区的交互作用，以及与阳性、阴性症状的相关性。结果·额叶-边缘系统功能连接的组别主效应不显著（P=0.110），但分亚组时存在显著的亚组与脑区交互作用（P=0.049）。CHR-C组双侧眶额-双侧杏仁核的功能连接强度显著低于健康对照组和CHR-R组（均P<0.05），3个CHR亚组左侧眶额-左侧海马功能连接强度均显著低于健康对照组（均P<0.05）。CHR-C组左侧眶额-右侧杏仁核功能连接异常与阴性症状严重程度呈显著正相关（P<0.05），而左侧眶额-双侧海马及右侧眶额-左侧海马功能连接异常与阳性症状严重程度呈显著负相关（均P<0.05）。结论·CHR患者可能普遍存在眶额-海马功能连接降低，而眶额-杏仁核功能连接低下可能对CHR患者后期转化为精神分裂症有一定的预测作用。

Objective · To explore the role of functional connectivity (FC) within the fronto-limbic network in predicting the onset of psychosis in the subjects with clinical high-risk for psychosis (CHR). Methods · A total of 164 CHR subjects and 89 healthy controls (HC) who underwent resting-state functional MRI were recruited. FCs between frontal [medial prefrontal cortex and bilateral orbitofrontal cortex (OFC)] and limbic (bilateral hippocampus and bilateral amygdala) brain regions at baseline were calculated. CHR subjects were further divided into 3 subgroups, i.e., CHR converters (CHR-C) group, symptomatic CHR (CHR-S) group and remitted CHR (CHR-R) group according to clinical outcome after one-year follow-up. The FCs of fronto-limbic network were compared between the groups and among the subgroups, and their interaction with brain regions, as well as their correlations with positive and negative symptoms were analyzed. Results · There was no significant main effect of group (P=0.110), but a significant interaction of subgroups and brain regions (P=0.049). CHR-C group had lower FC between bilateral OFC and bilateral amygdala than HC group and CHR-R group (all P<0.05). The FCs between left OFC and left hippocampus in the three CHR subgroups were all lower than that in HC group (all P<0.05). In addition, the FC between left OFC and right amygdala was positively correlated with the severity of negative symptoms in CHR-C group, while the FCs between left OFC and bilateral hippocampus and between right OFC and left hippocampus were negatively correlated with the severity of positive symptoms in CHR-C group. Conclusion · The decrease of OFC-hippocampus connectivity may be common in the subjects with CHR, while the decrease of OFC-amygdala connectivity may predict CHR subjects will convert to schizophrenia in the later stage.